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June, 2003

A Health Care Plan That Will Lower Costs And Improve Health
By Stephen Simac


    I fearlessly predict that during the '04 presidential campaign each Democratic candidate will have his own health care plan "for every American."   Bush possibly has one with a war theme in the works, right now he's reducing VA care and wants to privatize Medicare.
   It's unlikely any of their plans will become law no matter who wins the election, or is appointed.  Even if enacted American's health would not improve under a plan that could meet political approval.  Because so many powerful interests in our economy are invested in increasing illness and injury and overall medical costs they can block any true reform.
  Current trends in medical costs ensure that every child born today owes most of their entire life wages for parents and grandparents "health" care.  Throw in military costs and the children of America essentially are born slaves for the next century to the debts of their forebears.    The entrenched, vested interests in the present medical delivery system, and they are legion, argue over who should get a bigger slice of the trillion plus dollars spent on health care by Americans every year. Not one vest wants to reduce their contribution to the costs. 

Eeenie, Meenie Minie, Moe
    Democrats' Gephardt, Kerry and Kean have each taken first cracks at reforming the system, like Don Quixote going at the windmill once again. Their biggest idea for cutting costs is to reduce administrative costs. Potentially this could save a few dozen billion or so. Until you actually try to do it.
   They're tinkering around with how to provide insurance 'for every American', or more than now at least.  Kerry and Kean pledge to do it for a little more than the War on Iraq.  Gephardt plans WWII type costs. Lieberman wants to spend another $150 billion on "Cures" as if 'the search for cures' weren't part of the problem in spiraling medical costs.
   Most analysts see an inevitable collapse of the American medical system because of financing.  It may be the best thing that could happen to our health.
   No candidate mentions that insurance coverage almost doubles the cost of health care, mainly because of "administrative costs." They all want to put more money into medical insurance, not less.
   The truth is that uninsured people actually lower overall medical costs, mainly because they seek less care. When they do land in the ER the hospital still has less paperwork and authorization time needed, and can profit from Free Care pools.
   My plan would lower medical costs by canceling all insurance and adequately funding Free Care from service charges and sin taxes. Those who want a single payer plan should throw their weight behind this. It could be funded for around half of current costs. Insurance shills Harry and Louise are going to froth at the mouth in television ads over this solution even though it's less complicated than Hillary Clinton's plan.
   Like any good plan it contains plan B if that is too radical.  B subsidizes only catastrophic insurance for everyone. People are charged a sliding scale for the health care they need or choose based on their economic factors. Insurance companies pay the catastrophic costs and are guaranteed appropriate profit for acting as a brake on out of control medical costs.  All the monies now spent on medical insurance by various sources and sin taxes would fund them. Make the devil pay for once.
   Insuring appropriate medical care for everyone shares the pain and prevents financial catastrophe for individuals and families because of an illness or injury.   It speaks to most Americans' fear about our current system.

Catch A Tiger
   Healthy Americans are significantly cheaper to profitably insure than the sickest patients, but even their rates are unaffordable now. They are charged more to help pay for the total costs of the insured pool.
   Healthier people provide hefty profits those insurance companies currently blow on buying commercial real estate, paying inflated CEO salaries and other "administrative costs." Insurance companies bleed money to pay for the sickest Americans and that's why they try to dump them onto the state Medicaid plans if they can. Most of which are already broke.
   Insurance has encouraged medical costs in the United States to rise higher than the rate of inflation since WWII. Because an insured individual or family doesn't have to pay for all their medical costs, medical technology and treatment choices have been skewed towards greater costs and more treatment for every condition. Even if it doesn't help.
   It's built in to the system, enabled by insurance because businesses, individuals, families and taxes substantially paid for enormous costs of the few.  As insurance rates continue to go through the roof individuals and families will be forced to pay more of the actual costs of their coverage as businesses and governments seek to cut costs.
   They will look for an easy fix and a scapegoat. The minority of sickest and oldest patients with the majority of medical costs will increasingly be blamed for the high cost of insurance.
   Most of these patients could be treated at far less cost by the medical system and be provided the same level of help.  Some would be helped just as effectively with no treatment.  But these changes would threaten the foundations of medical structure. Instead the individual will be blamed for institutional practices. Patients' lifestyle choices will be held against them. Trouble is every one has a couple of unhealthy habits.

   The sickest will be blamed for their sloth, lust and gluttony, their pessimistic nature, their risk taking habits, their bad genes or just for growing old and not dying at a decent age.
 
   Many of these patients will be bumped out of the insured pool. They will even be removed from state funded Medicaid programs, as is already happening.

By The Tail
   The states have started the trend to increasing the uninsured but are also cutting back on free care pools. Hospitals will threaten bankruptcy because of increased emergency room visits and some will close. Many hospitals are almost there now because their fixed costs are enormous.
     Hospitals are powerful job centers for a community but they are hardly the most economical way to provide health care.
  Their level of waste approaches the military and that's job security. Hospitals are a good place to store large and expensive medical equipment, a major cause of hyperinflationary costs for medical treatment.
   Throw in a SARS quarantine and most American hospitals will go under without enormous bailouts. Because of their size they can never become a lean and mean fighting machine. They're like a battalion of tanks with their treads blown off.
    American ER's are excellent for trauma care but they tend to make every visit a trauma. Emergency rooms serve the medical needs of last resort and they should not have to be used for routine health care. My plan ensures that most 'emergencies' and routine health care would be taken care of in widely distributed community health centers with a minimum of investment, comparable to the costs of one nuclear submarine. An aircraft carrier would put them in every neighborhood, operating 24/7 like convenience stores. Residents of the neighborhood could work for them and walk to work.
    Mainly because of vehicular traffic, alcohol and jackass behavior, Americans definitely need trauma centers. The number and severity of accidents could easily be reduced but there are powerful vested interests obstructing this.
   The certainty of major illness because of cigarette smoking, typical diets and lack of exercise could certainly be reduced with education, encouragement, engineering and some enforcement.  Even more powerful interests fight any reform there.
   The hospital is the end result of a health care philosophy that emphasizes bringing the patient to the medical provider instead of the other way around, and treating symptoms not preventing causes.  Health care in the home or community or with widely dispersed treatment centers can care for most illnesses, injuries, birthing and dying at far less costs than hospitals and with better outcomes over all.

Catch A Fire
    All the candidates plan to provide free drugs for seniors, but they really mean prescribed pharmaceuticals. My plan would put pot in every garden and provide free chicken soup. It would legalize cannabis for every symptom it alleviates, and they are legion. It won't help everybody, but those it does help know who they are. Patients or their caregivers can grow their meds in their own garden.
    Since adverse drug reactions are estimated to kill over a hundred thousand Americans every year, their plans attempt to lower health care costs through increased attrition. No matter what lies the government spews about cannabis, the fact remains no one has ever died directly from a cannabis overdose.  There are health problems associated with extended and excessive smoking of pot but most of these can be prevented through education and vaporizers. Even DEA administrative judge Francis Lawn declared marijuana is the safest known drug when he ruled in 1987 that the feds should make it available for medical prescription.  The feds are still resisting his order that marijuana be removed from Schedule I with no allowed medical use.
   The price of new pharmaceuticals has risen at 2-3 times the cost of inflation for decades. That doesn't even include their adverse reactions.  For every person killed another ten or so have serious medical complications. This creates more medical costs, and more drugs prescribed.
   If you believe the hype there's a new and improved drug for every condition, at least if there's some one who will pay for it. The other candidates want to further indebt their grandchildren to give free drugs to the elderly. For this country to buy free pharmaceuticals for the aging at current rates of increase would be more expensive than colonizing the entire Middle East. And at least oil could pay for some of that.
  My plan would provide free drugs for everybody if they grow their own or go to their neighborhood clinics. Every doctor in the new American armada of neighborhood clinics will be given unlimited sample packs of placebos. Different colors of course. The physician can honestly say, "try this Pink Placebo Pill, it's been found to be very helpful for many people with your condition." Chicken or vegetarian soup will be provided free at these clinics, even delivered with placebos to the homebound. Vitamins, minerals, herbs, and other affordable remedies will be subsidized. If they want FDA approved pharmaceutical drugs they will have to pay for them on a sliding scale.
    Some drugs work better than placebo for some conditions, but no drug works better for all conditions than placebos. Medical education has worked hand in latex glove with drug companies to emphasize that health care means legal drug prescription.

My Mother Says
    Simple lifestyle changes are just as effective as most drugs in reducing symptoms and prolonging healthy life.  Most of the costs of medical care could be reduced significantly by individual or social changes. Those changes are not included in any presidential candidate's plan, and would make it DOA if they were.
   Americans have heard and ignored the well known lifestyle effects on health for decades, you know like getting minimal exercise, eating a moderately fatty diet, not smoking tobacco, and wearing a seat belt.
  It's going to be much harder than invading Iraq to get Americans exercising more and eating better but my plan contains "top secret, national security" measures to accomplish this.  I'm offering my plan freely to any presidential candidate.  I predict they will not choose my plan's guaranteed reduction of medical costs through eliminating insurance or providing catastrophic coverage only, legalizing and taxing sins, closing hospitals and opening 24/7 neighborhood clinics, pot in every garden, free placebos and chicken soup, and promoting wellness lifestyles. Unfortunately for the health of Americans and the debts of their grandchildren, this plan would kill their presidential chances as effectively as a plane crash. 

 

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